Frequency of prognostically important acute myeloid leukemia mutations in the Iranian population: A systematic review and meta-analysis.

Background: The geographic diversity of molecular genetic abnormalities in AML can help understand the genetic and environmental factors involved in the development of leukemia. In addition, high-risk groups can be recognized by identifying common mutations in AML patients, and appropriate treatment based on the type of mutation can be adopted. This systematic study and meta-analysis analyzed the common mutations in AML patients in Iran. Methods: In this systematic study, common mutations in Iranian AML patients were comprehensively examined across four databases: PubMed, Scopus, Web of Science, and Magiran, from 1980 to 2024, following the PRISMA guidelines. Meta-Analysis Version 2 (CMA2 was used for data analysis, and I²-test values greater than 50% were considered to indicate high heterogeneity among the studies. Results: By reviewing 40 articles, it was found that the prevalence of FLT3-ITD mutation was 21.9% (CI: 19.19 - 24.1) in 34 studies (3,152 AML cases), FLT3-TKD mutation 6.6% (CI: 4.7 - 9.3) in 19 studies, NPM1 mutation 19% (CI: 15.9-22.6) in 18 studies DNMT3A mutation 13.9% (CI: 11.1 - 17.2) in 5 studies, CEBPA mutation was 18.5% (CI: 10.3 - 31) in 5 studies, and WT-1 mutation prevalence was 8.2% (CI: 5.6-11.8) in 4 studies. Other mutations investigated in the studies included NRAS, IDH1, IDH2, TET2, c-kit, ASXL1, and RUNX1. Conclusions: Studies have shown that the FLT3-ITD mutation is the most prevalent mutation among Iranian AML patients. Following this, the most common mutations identified were NPM1, CEBPA, DNMT3A, and WT1, in that order.